- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $6,456.54 / $18,620.87
| Facility | | $3,162.28 | $6,456.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $15,488.17 / $15,848.93
| Facility | | $14,791.08 | $15,488.17 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $16,982.44 / $16,982.44
| Facility | | $630.96 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,137.96 / $10,232.93
| Facility | | $1,318.26 | $2,137.96 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $6,918.31 / $18,620.87
| Facility | | $2,884.03 | $6,918.31 | $18,620.87 |